Category Archives: Executive Function

I’m putting the blog on hiatus for the month of August. Some more details at the end of the post if you’re interested.

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Back in March, someone left a comment on the self-employment series asking me to share some of the ways I manage my executive function challenges in the context of work. With an amusing mix of irony and executive function fail, I’m just now getting around to writing the promised post.

One of the reasons I’ve been avoiding writing this is that I couldn’t figure out how to approach it. Should it be a list or a narrative? Does it need examples? How detailed should it be? There was also the nagging fear that maybe all of my executive function hacks are plain old common sense.

Back when I was fourteen and an aspiring doctor, someone recommended that I read “The Making of a Surgeon” by William Nolen. It was a memoir of Nolen’s progression from med school student to surgeon and I excitedly dug into it, hoping for insight into what med school would be like. Only to be disappointed when one of the first grand bits of wisdom that the author offered was how he learned to do multiple chores at one time–literally to pick up records, drop off samples and get his lunch all in the same trip rather than making three separate trips from his unit to do each errand individually.

I remember lying on my bed thinking, “How on earth did this man get into such a prestigious medical school?” It seemed like a no-brainer to me that if you had three things to do, the best option would be to do them in a geographically efficient sequence.

This is part 4 in a series about executive function. After wrapping up the discussion of regulatory functions with some thoughts about Cognitive Flexibility, it talks a bit about some models of EF and how the various pieces fit together. Looking for the other parts? Part 1 | Part 2 | Part 3

In a more formal sense, it’s the ability to shift your thinking or attention is in response to changes in the environment or situation (such as new rules, information, demands or goals). If you’ve ever wondered where the autistic tendency toward rigid thinking and routine comes from, this is it. Change requires cognitive flexibility. It’s not necessarily that we don’t want to do things differently. Impaired executive function makes it harder to adapt to change by forming new thought or behavior patterns.

Variation in executive function capacity can explain why one day it’s not a big deal if the bus is five minutes late or your favorite shirt is in the laundry but on another day, this kind of small disruption to routine triggers a meltdown. What appears to be a fit of irrationality is actually a failure of the prefrontal cortex to cope with change in the expected way.

Cognitive flexibility also refers to considering multiple aspects of a situation at the same time, such as seeing opposing points of view or multiple characteristics of an object. When you think about it, there is little difference between “lack of empathy” or “impaired theory of mind” and impaired cognitive flexibility. Not seeing the other person’s point of view can be as simple as having difficulty seeing multiple aspects of a situation at the same time.

Finally, cognitive flexibility includes task switching, which is sometimes listed as a separate component of executive function. Difficulties with task switching are what make it hard to stop playing World of Warcraft and start making dinner. Or to pick up where you left off on a task after being interrupted. Poor task switching is also why people will often say that autistic people are so good at doing repetitive tasks. It might be more accurate to say that we’re not very good at stopping. Continue reading Executive Function Primer (Part 4)→

This is part 3 in a series about executive function. It looks at the regulation functions that are related to initiating, monitoring and inhibiting our actions and thoughts. Looking for the other parts? Part 1 | Part 2

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The second category of executive function components, regulation, includes cognitive flexibility and the initiation, monitoring and inhibition of actions. These executive functions are primarily related to how we interact with our environment.

Inhibition

When you think of inhibition, you probably think of the common usage which means a feeling of self-conscious restraint. The inhibition related to executive function is somewhat different. It refers to our ability to block or suppress a thought or action, either consciously or subconsciously.

Biologically, inhibition takes place in three different realms: motor inhibition, cognitive inhibition and emotional inhibition. It’s quite possible that you’ve never even thought about inhibition in this way and yet it has a huge impact on your daily life.

Our brains are constantly inhibiting–or failing to inhibit–thoughts and actions. To focus attention on one thing, we have to inhibit countless other distracting inputs (remember the top-down and bottom-up attention systems as well as selective attention). To call up a desired piece of information from memory, we have to inhibit the retrieval of millions of irrelevant bits of information. To change a behavior we have to inhibit habitual actions. And sometimes, to get through a difficult situation, we have to inhibit our emotional reactions (or, if you’re alexithymic, consider the opposite case–your emotions are involuntarily inhibited, perhaps in part because of dysfunctional inhibition).

When you think about it, a lot of autistic traits could be traced back to poor inhibition. Infodumping, even when we know the other person has lost interest. Catastrophizing long past the point where it’s logical. Blurting out what we’re thinking only to regret it a split second later. Spending the day lost in a special interest when we really did mean to get all those chores done. Even stimming could be viewed as poor motor inhibition. What if all people have a natural tendency to stim, but neurotypical people are just better at naturally inhibiting their motor function?

Extreme difficulty with inhibition can lead to impulsivity, which is more characteristic of ADHD than autism, but can be present in both. Often, impulsivity is mistaken for problem behavior and met with punishment as a means to extinguish the problem. Like other aspects of dysfunctional EF, poor inhibition isn’t something that can be fixed by simply trying harder or having more self-discipline. Support can help. Accommodations can help. Understanding can help. Practice can help. Punishment and shaming only hurt. Continue reading Executive Function Primer (Part 3)→

This part 2 in a series about executive function. It looks at the remainder of the organizational functions that were introduced in part 1 : problem solving, verbal reasoning, working memory and attention.

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Problem Solving

Problem solving is another umbrella term, encompassing the activities related to identifying and overcoming obstacles to reach a predefined goal. Probably the most complex cognitive process that we engage in, it draws on nearly all of the other aspects of executive function.

Here is the traditional problem solving cycle, with related EF components in parentheses:

Identify the Problem (attention, initiation of action, monitoring of actions, working memory)

For me, that list is missing a very critical step: Recognize That a Problem Exists. Because this is where I often run into trouble with problem solving. I’m pretty good at reasoning out solutions to a defined problem. Not so good at actually recognizing the presence of a problem. And that’s executive function too.

And again there is an ironic twist lurking under the surface here: when someone else is having a problem, what is the default autistic response? Fix it! Come up with a plan! Whether they want us to or not.

I’ve written a lot about executive function, but I realized recently that I don’t have a post that explains what EF is. I set to write one post and 4000 words later, I have a short series. This is part one. The three remaining parts will be posted over the next two weeks.

So what the heck is executive function, anyhow?

Executive function is a broad term that refers to the cognitive processes that help us regulate, control and manage our thoughts and actions. It includes planning, working memory, attention, problem solving, verbal reasoning, inhibition, cognitive flexibility, initiation of actions and monitoring of actions.

That’s a nice concise definition, in theory, but what does EF look like in real life?

In practice, executive function is a slippery concept. Sometimes it looks like responsibility. Sometimes it looks like self-discipline. Sometimes it looks like being a competent adult.

If you have poor EF, people might mistake you for being disorganized, lazy, incompetent, sloppy, or just plain not very bright. Why? Because executive function encompasses so many essential areas of daily living. Nearly everything we do calls on areas of executive function. Cooking. Cleaning. Parenting. Work. School. Self-care. Continue reading Executive Function Primer (Part 1)→

There’s a spot on my kitchen floor, a little cluster of dried reddish drips. I don’t know what it is. If it’s from 3 days ago, it’s tomato sauce. If it’s been there longer . . . who knows.

I’ve walked past it dozens of times. I look at it. It annoys me. I wonder how it got there. I wish it would go away. It doesn’t occur to me that I can make that happen.

The greasy smudgey fingerprints on the cabinet that I can only see in exactly the right light? The 8-inch long thread that’s been hanging off the bathroom rug since the last vacuuming? The dryer sheet on the laundry room floor? Same thing.

What is this? Why can I sit here and catalog all of these little annoyances yet I still do nothing about them? It’s not like fixing them would take a huge amount of time or effort.

In fact, to demonstrate how minor they are, I’ll take care of them right now.

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Done. It took me less than five minutes to wipe down the kitchen cabinets, trim the thread and toss in the trash, pick up the dryer sheet, and clean the spot off the floor. I bet it would also take only a few minutes to vacuum up the bits of dirt and grass scattered in the entryway from my running shoes.

The Scientist has proposed a 30-day experiment. He says I need to practice doing what I want to do. He says, in addition to being good for me, it will help him to get to know me better. We’ve known each other for 28 years, so this feels a little late in the game for getting to know each other better. And yet . . .

What really intrigued me about his proposal is how it might help me get to know myself better. If you’re a long time reader, you might remember that last year I wrote about how much difficulty I have figuring out what I want. I often haphazardly make minor decisions, only to find I’m unhappy with the results. Here’s an example, the one that sparked the idea for the experiment:

I tried out a new recipe for dinner last week–a light summer mix of fresh tomatoes, red onions, squash and fried okra from the farmer’s market. When The Scientist tasted it, he said the flavor was too strong for him but he’d make some pasta to toss the veggies with. Since I was already cooking, I made the pasta, and for some reason I mixed all of the veggies with the pasta instead of setting my half aside. The resulting pasta dish tasted okay, but it wasn’t what I had in mind when I chose the recipe.

After dinner I was feeling gloomy, silently perseverating. As we were sitting down to watch TV, I blurted out, “I have no idea why I ate that. It wasn’t what I wanted.”

The Scientist, surprised by how upset I was, asked why I ate it if I didn’t want it. My answer: “I don’t know.”

A longish discussion ensued. The next day. Because we’re slow to process things. One of the conclusions we came to is that I sometimes do things to please other people at the expense of own preferences. Strangely, this seems to be more of a reflex action than a conscious choice.

So the experiment is this: for 30 days, I’m supposed to do whatever I want. This is alarmingly vague.

What do I want? Decision making–even the simplest decisions–can tie me up in knots. My primary decision-making strategies:

1. What do you want? I’ve noticed that other people often have stronger preferences or are more aware of what they want or like than I am. If what they suggest isn’t objectionable to me, I’ll go along with their choice. Decision making by proxy. Simple. Efficient. And probably one of the main reasons I have so much trouble figuring out my own wants and preferences.

2. I don’t want A. By default I must want B. If someone says “do you want Chinese food or Pizza?” it rarely occurs to me that I actually want a burger.

3. This is too hard. I give up. When there are too many options, I don’t know where to start. I choose the first option that isn’t terrible. These are often the choices I end up feeling most ambivalent about.

4. I want A but it’s too much work. I’ll just settle for B. This is how I made decisions when I’m overloaded. I would love ice cream right now but going out to get it sounds exhausting so I’ll have this peach instead.

5. I want this thing and nothing else. This sounds great. It’s not. What I want is often imaginary. In my head it’s this perfect thing. In reality, it turns out to be a pale shadow of what I anticipated.

6. I want A, but I can tell you want B. If one of us has to be disappointed, I’d rather it be me. This makes me sound like such a martyr. Honestly, it’s an annoying reflex response that I need to cure myself of. Done too often, it breeds resentment.

Writing this out helps me understand better why I often feel ambivalent or unsatisfied with minor decisions. I need new strategies. The Scientist says to try just feeling it. This is hard. I’m used to making decisions based on logic and reasoning.

But . . . 30 days of being with this question of “what do I want?” might change that. We’ll see.

What People Are Reading

Yesterday I ventured way way way outside my comfort zone to record an interview on Autism Spectrum Radio. The host, Rob Haupt, asked some great questions and was easy to talk to. You can listen to our conversation here. Rob does a short intro and then the rest of show (about 35 minutes) is our conversation.

My friends Ibby Grace And Amy Sequenzia are editing an anthology titled “Typed Words, Loud Voices”, a collection of works by people who type to talk always or sometimes. They’re looking for essays, poems, stories or whatever form of expression you’d like to share your message in.

As some of you noticed yesterday, I’ve updated the blog theme to add a little color. Maybe down the road I’ll experiment with some of the new features (like this one that allows short “aside” posts). It’ll take some getting used to, I know.

And yes the remodeling is an indication of just how bored I am with all the not writing I’m doing.

Triathlon training is chugging along nicely – 3 weeks to go and I feel great, if a bit worn out. The garden is producing lots of cucumbers and tomatoes, a few eggplants and peppers. And for some reason I’m the only person on earth who can’t grown squash? With the exception of one green squash a couple of weeks ago, all I’m getting are tiny little squash that turn yellow and wither.

Besides a renewed obsession with The Sims, that’s about all that’s new around these parts.